PB0918 - Clinical Presentation and Outcomes of patients with cancer-associated isolated Distal Deep Vein Thrombosis

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Presenting Author(s)

Jean-philippe GALANAUD, MD (he/him/his)

Staff Physician, Department of Medicine
University of Toronto
Toronto, Ontario, Canada

Co-Author(s)

JT

Javier Trujillo-Santos

Dr
Internal Medicine Department. Hospital Universitario Santa Lucía. Complejo Hospitalario Universitario de Cartagena. Murcia.
Cartagena, Murcia, Spain
Behnood Bikdeli

Associate Physician, Section of Cardiovascular Medicine
Brigham and Women's Hospital, Harvard Medical School
Boston, Massachusetts, United States
Laurent Bertoletti, MD, PhD (he/him/his)

MD, PhD
Service de Médecine Vasculaire et Thérapeutique, Centre Hospitalo-Universitaire de Saint-Etienne ; INSERM CIC 1408 CHU de St-Etienne; INSERM UMR 1059, Université Jean Monnet, Saint-Etienne ; FCRIN INNOVTE, France.
Saint-Etienne, Rhone-Alpes, France
CF

Conxita Falgá

Staff Physician
University of Barcelona
Barcelona, Catalonia, Spain
MZ

Marija Zdraveska

Staff Physician
Skopje University
Skopje, Skopje, Macedonia
JL

Jorge Lima

Staff Physician
University of Sevilla
sevilla, Andalucia, Spain
FR

Francisco Rivera-Civico

Staff Physician
Hospital de Poniente
Almeria, Andalucia, Spain
JF

Josefa Fernández

Staff Physician
Pius Hospital de Valls
Tarragona, Catalonia, Spain
Manuel Monreal, PhD, MD

Senior consultant
Universidad Catolica de Murcia
Barcelona, Catalonia, Spain

Background: Patients with isolated distal deep vein thrombosis [distal DVT] have lower rates of adverse outcomes (death, venous thromboembolism [VTE] recurrence or major bleeding) than patients with proximal DVT. Several studies have reported that, in the setting of cancer, risks of adverse outcomes were not different between patients with distal and proximal DVT.

Aims: To assess in a large, prospective and international way the prognosis of patients with cancer-associated distal DVT (CA-iDDVT).

Methods: Using data from the international RIETE registry, we compared the risks of adverse outcomes at 90 days (adjusted odds ratio, aOR) and one year (adjusted hazard ratio, aHR) in 886 patients with CA-iDDVT versus 5,196 patients with cancer-associated proximal DVT (CA-Proximal DVT); and 5,974 patients with non-cancer-associated distal DVT (NCA-iDDVT).

Results: Over 90% of patients in each group were treated with anticoagulants for at least 90 days. At 90 days, the adjusted risks of death, VTE recurrence or major bleeding were lower in patients with NCA-iDDVT than in patients with CA-iDDVT. Results were similar at one-year follow-up (Figures 1 & 2).
Risks of death, VTE recurrence and major bleeding were not statistically different between patients with CA-iDDVT versus CA-Proximal DVT, both at 90 days: aOR=1.11 (95% CI: 0.91-1.36), aOR=1.10 (0.76-1.62) and aOR=1.18 (0.76-1.83) respectively, and one year: aHR=1.01 (95%CI: 0.89-1.15), aHR=1.02 (0.76-1.35) and aHR=1.10 (0.76-1.61) respectively. However, more patients with CA-Proximal DVT, compared with CA-iDDVT, developed fatal pulmonary embolism (PE) during follow-up: risk difference was +0.40% (95% CI: +0.23% to +0.58%).

Conclusion(s): CA-iDDVT is associated to a higher risk of overall death, VTE recurrence and major bleeding than NCA-iDDVT. It has similar risks of overall death, VTE recurrence and major bleeding than CA-Proximal DVT, but lower risk of fatal PE. This suggests that CA-iDDVT is a serious but less severe form of VTE than CA-Proximal DVT.